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Why You Should Not Use Cold Therapy for Acute Injuries

Should you use ice for injuries?

We’ve been told that using ice for acute injuries is okay because there’s swelling and blood flow, and you want to reduce inflammation. Of course, this is logical. Everyone knows it is true that one should follow the rice RICE protocol when you have an injury. The RICE protocol is:

· Rest

· Ice

· Compression

· Elevation

But, having been a healthcare professional for years, I can tell you that there were a lot of supposedly true things, and everyone knows that they are accurate and end up being false.

For example, I couldn’t find evidence that using ice for acute injuries improves your recovery or returns you to your normal state.

Of course, ice does indeed help decrease pain. However, it also has anti-inflammatory effects because it creates a vasoconstriction effect. This means that it pushes blood out of an inflamed area.

But, there is a question. Is it necessary to reduce inflammation? Is the inflammation in acute injuries pathological? Does it have a negative impact on the body? Something that should be gotten rid of? It may be in a chronic state but not in an acute form.

Photo by Jan Antonin Kolar on Unsplash

Is inflammation a bad thing?

Inflammation is good in an acute state, that is, in the short run. It is part of the natural response by your immune system to fight an infection or heal an injury. After it has done its job, the inflammation is supposed to stop. However, if it continues as a long-lasting habit in your body, that can be bad for your health. Long-term inflammation, also known as chronic inflammation, is seen in many health conditions and diseases.

It is important to note that inflammation is a fundamental part of the healing process. During inflammation, there is an increase of macrophages to help clean up the affected area. There is also an increase in oxygen, nutrient-rich blood, and hormones like Insulin-like growth factor 1. So, inflammation becomes a complex, coordinated effect of your body trying to heal an area.

Why you should not use cold therapy for acute injuries

The other name for cruel treatment is cryotherapy. Cold therapy works by reducing the flow of blood to a particular area. This can reduce swelling and inflammation significantly, especially around a tendon or a joint. Cold therapy can temporarily reduce nerve activity, which in turn relieves pain. That’s what we’ve been told.

However, applying ice or cold to inflammation stops the inflammation cascade. We’ve seen the complex and coordinated effect of inflammation in healing acute injuries precisely.

Applying ice inhibits recovery. It slows down the repair process. It delays normal function. Cold therapy has a decreasing effect on pain, but this comes at the expense of inhibiting recovery.

Also, taking medications like NSAIDs slow the repair process because they slow inflammation. As such, the key to repair is not to reduce inflammation prematurely.

Other things to avoid for acute injuries

Avoid using heat on acute injuries because it will probably increase swelling, inflammation, and pain.

Here’s an important question: “does rest improve recovery?” No, it does not. Rest slows your recovery because your lymphatic system is not equipped with a pump and requires motion to push things out of it, so the more you rest, the less recovery you will get. On the other hand, there’s usually plenty of waste in the lymphatic system after an acute injury, so what’s the best thing to do?

What to do for acute injuries

Be active

Put as much motion as you can into that joint. Of course, the concept of motion does not apply if it is fractured, but if it is strained or sprained, you’ll want to put a passive range of motion or, in some cases, a dynamic range of motion depending on the severity of the injury. More motion will activate more lymph and circulation and speed up your recovery.

Infrared therapy

This is excellent therapy. It simply involved putting a light into a specific body area. Infrared therapy has been proven to improve the recovery of an injury. Infrared therapy can dramatically decrease pain as well.

Vitamin D

Vitamin D is essential for a robust immune system and helps to defend the body against acute illness and injury. Low levels of Vitamin D are associated with increased inflammatory markers in endurance athletes. If you have any acute injury or pain, a higher dosage of vitamin D in the range of 40,000 IUs daily for probably a whole week can speed up recovery.

Manual therapy opposite side

This is an exciting technique. It is counter-intuitive. Chiropractors have used it in practice for many years. So, for example, if you injured your right ankle, you would apply manual therapy to your left ankle. This might sound weird, but you lose nothing by trying it. You see, all the nerves on the right side of the body are connected to the left side of the body through the spinal column, and when you work on the left side of the body, it affects the right side of the body because it is on the same circuit.

It is important to note that neurological circuits are embedded in your muscles to allow for easy coordination so you can walk and perform certain motions.

Manual therapy includes:

· Massage

· Trigger point therapy

· Or any stimulation


Cold therapy inhibits recovery from acute injury. It slows down the repair process. It delays normal function. True, cold therapy has a decreasing effect on pain, but this comes at the expense of inhibiting recovery.

More practical options include:

· Manual therapy opposite side

· Infrared therapy

· Vitamin D

· Physical activity

Disclaimer: Dr. Berner does not diagnose, treat, or prevent any medical diseases or conditions; instead, he analyzes and corrects the structure of his patients with Foundational Correction to improve their overall quality of life. He works with their physicians, who regulate their medications. This blog post is not designed to provide medical advice, professional diagnosis, opinion, treatment, or services to you or any other individual. The information provided in this post or through linkages to other sites is not a substitute for medical or professional care. You should not use the information in place of a visit, consultation, or the advice of your physician or another healthcare provider. Foundation Chiropractic and Dr. Brett Berner are not liable or responsible for any advice, the course of treatment, diagnosis, or any other information, services, or product you obtain through this article or others.


Bleakley CM, McDonough SM, MacAuley DC, Bjordal J. Cryotherapy for acute ankle sprains: a randomized controlled study of two different icing protocols. Br J Sports Med. 2006;40(8):700–705. doi:10.1136/bjsm.2006.025932

Foley J, Vasily DB, Bradle J, Rudio C, Calderhead RG. 830 nm light-emitting diode (led) phototherapy significantly reduced return-to-play in injured university athletes: a pilot study. Laser Ther. 2016;25(1):35–42. doi:10.5978/islsm.16-OR-03

Onderko LL, Rehman S. Treatment of articular fractures with continuous passive motion. Orthop Clin North Am. 2013;44(3):345-ix. doi:10.1016/j.ocl.2013.04.002

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